Active NPI
Ophthalmology Associates
- Ophthalmology Physician
- Edina, MN
National Provider Identifier
1902880461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- OPHTHALMOLOGY ASSOCIATES
- Practice address
- 6533 Drew Ave S
Edina, MN 55435 - Phone
- (952) 927-7138
- Fax
- (952) 924-4021
- NPI assigned
- Nov 30, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Leslie Walter Jacobson, M.D.
- Title
- Dr
- Phone
- (952) 927-7138
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | Primary |
Addresses
Primary practice location
6533 Drew Ave S
Edina, MN 55435
Mailing address
6533 Drew Ave S
Edina, MN 55435
Phone (952) 927-7138
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040602000864 | MN | Part B Supplier - Clinic/Group Practice | 5991787103 |
Receives reassigned benefits from 7 practitioners Practice locations: Edina, MN |
National Provider Directory
National Provider DirectoryLocations
4100 Minnesota Dr
Fl Second
Edina, MN 55435
4100 Minnesota Dr
Fl 2
Edina, MN 55435
6533 Drew Ave S
Minneapolis, MN 55435
Phone (952) 924-4038
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1322438400000",
"number": "1902880461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6533 DREW AVE S",
"city": "EDINA",
"state": "MN",
"postal_code": "55435",
"telephone_number": "952-927-7138",
"fax_number": "952-924-4021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6533 DREW AVE S",
"city": "EDINA",
"state": "MN",
"postal_code": "55435",
"telephone_number": "952-927-7138",
"fax_number": "952-924-4021"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OPHTHALMOLOGY ASSOCIATES",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-30",
"last_updated": "2011-11-28",
"status": "A",
"authorized_official_last_name": "JACOBSON",
"authorized_official_first_name": "LESLIE",
"authorized_official_middle_name": "WALTER",
"authorized_official_title_or_position": "DR",
"authorized_official_telephone_number": "952-927-7138",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.